Understanding and diagnosing headache in animals

To be able to successfully treat and relieve headaches in companion animals, we first have to notice and “diagnose” them, while remaining undeterred by the fact that absolute proof remains unattainable.

Headache ranks among the most common local pain complaints in humans. According to the National Headache Foundation, there are an estimated 45 million human headache sufferers in the United States.

Headaches are triggered by a multitude of causes. In people, they can be part of a symptom complex associated with brain illness (concussion, encephalitis, brain cancer, etc.). Most other secondary, and most if not all, primary headaches in young, still non-verbal children, remain largely undiagnosed. The same applies to many of our companion animals; their headaches are still among the health conditions that have eluded science. But common sense suggests that any creature with a head and pain perception also has the basic capacity to suffer from headaches.

Headache symptoms

Nearly 20 years ago, during my veterinary chiropractic training with the AVCA (American Veterinary Chiropractic Association), I became aware of the possibility of headache in animals. Since then, I have seen quite a number of patients whose symptoms resolved after a treatment approach geared toward what I suspected to be headache. When I mention the possibility of headaches in an animal, my colleagues or the animals’ guardians often give me a surprised “cocker spaniel look” followed by the question: “But how can you tell?”

The answer varies depending on whether you’re evaluating a specific animal, or discussing headaches in general. In an individual animal, the symptoms may be subtle or few. When looking at symptoms that could reflect headaches in general, however, the list of possible symptoms is long, though often unspecific.

A disappearance of symptoms the owner failed to previously mention, which fit into the overall picture of headaches, can be seen as a retrospective diagnosis. For this individual animal, it is less important that the “diagnosis” was a headache than that we made the animal feel well again. Collectively, symptoms resolving with treatment show that animals do have headaches that can be successfully treated.

Symptoms I have observed include:

• Hyper reactive to or averse to touch (specific to head or poll or neck; from shoulder forward); generalized to whole body in strong headache

• Defensive behavior upon approach (dog cringes, horse pins back ears)

• Hyperactive (in horses – nibbling, can’t stand quietly in stall/cross ties, paces in paddock), (in dogs – paces in pen, house or yard)

• Ataxia, clumsy, unresponsive

• Sweating on forehead or ears (horse)

• Lowered head or elevated head posture

• Vertebral /chiropractic misalignment of mainly scull/atlas and /or atlas/axis connection

• Reactivity to craniosacral work along scull sutures or poll

• Hard to halter or collar

• Hard to groom and tack up

• Skittish, irritable, aggressive, spooky

• Head shaking, head pressing, or staring

• Furrowed brows, squinty eyes, worried look, frequent blinking, distressed or dull expression

• Tight mouth/jaw

• Incomplete full body shakes

Additional symptoms known from humans, possibly observable in animals, include tearing, eye redness (same side as headache), nasal congestion or discharge, constriction of the pupil (miosis), drooping of the upper eyelid (ptosis) on the affected side, blindness, seeking out dark/quiet to rest, vomiting, photophobia, phonophobia (sound sensitivity), “aura” (if present, this is most commonly visual, but it can also involve motor problems), neck stiffness, fatigue, difficulty concentrating, “inconsistent performance”, and incoordination.

Causes of headache

Some of the causes of headache in animals are human-induced (and can therefore be species specific, such as ill-fitting gear used on horses). Others may well originate from sources similar to those known in human headaches. We may never know what played a role in a particular patient’s headache. Being aware of the range of possibilities may aid us in recognizing and treating it.

Causes of secondary headache include:

• After neck or head trauma, horse: Pull back, trailering, “neighbor teasing” and “fly mask tugging” through or above paddock fencing. Dog: slipping off grooming table while tied.

• Gear related: In horses, tight head piece, tight nose bands (via TMJ), long time use of blankets rubbing on breast and shoulders. In dogs, inappropriate crating.

• Dental problems: Horses with ramped molars can have problems with molar arcade alignment exerting pressure on the temporal mandibular joint. Dental treatment itself can also produce headache as the TMJ can get stressed in the process.

• Training related: Jerking on dog’s collar, “Rollkur” in dressage horses, tying an animal not ready to be tied.

• Chemicals: High carbon monoxide (smog, fires), high pesticide exposure, MSG, food and field spraying, nitrites in diet, pasture drought-stressed plants, pig weed.

• Hormone induced: Menstruation, hormone treatments, Calcitonin.

• Histamine induced: Allergies

• “Fasting”: Horses only being fed twice a day, especially with last meal already given in afternoon.

• Physical activity: Irregular, intense activity; let down periods, heat exhaustion.

• Seizures, inflammatory process in brain or body, tumors, malformed blood vessels in the skull or neck area

• Loss or change (owner, animal buddy, travel).

The causes of headache in TCM include:

1 External: Wind (hot, cold), Wind-Dampness

2 Internal: Empty – Qi deficiency, blood deficiency, Kidney deficiency; Full – Liver Yang rising, Liver Fire, Liver Wind, Liver Qi Stagnation, Stagnation of Cold in Liver channel, Wind-Phlegm, Food retention, Blood stasis, Stomach heat

Treating headaches in animals

Given the wide variety of headache causes, it is clear that resolving them will depend on the specific situation of the patient. We probably will not know the actual cause when starting to work with the patient. The joy of holistic modalities is that we can let the patient lead us by their responses to treatment. We may see “headache symptoms” resolve when we are apparently treating other problems. For instance, floating or pulling teeth may resolve headache-like symptoms. Behavior problems with the hint of headache may resolve as nutrition is improved. The cat stops staring at the wall as renal issues are improved with diet, fluids and holistic modalities. Did the cat have a headache? We may not know, but the symptoms resolved and the cat is more comfortable.

Chiropractic: This is one of the easiest and quickest ways to end a headache, if vertebral involvement is the cause. Human studies of spinal manipulation for tension headache and migraines yielded success rates between 28% and 90%. Any time there has been severe trauma in horses or other animals (flipped over, fallen down, got stuck, etc.), use chiropractic methods immediately. Do not wait for symptoms to appear.

Craniosacral therapy: This modality certainly makes sense for headaches. Adjusting the sutures of the skull, and connecting the energy flow from the head to the sacrum, helps multiple issues, including headaches. People actually feel their headache change location and intensity during a session. Horses tend to move during treatment, so the practitioner must be prepared to move along with the patient.

Tellington TTouch: In many cases, TTouch can be used to determine if an unwillingness to be touched is due to emotional or persisting physical factors. Emotional and mild physical causes (muscle tension) reliably resolve with TTouch. If hyper-reactivity persists, other treatment modalities are needed. TTouch is highly effective in quickly relieving negative body memory, restoring the animal’s trust of being touched again after physical causative factors are relieved through another modality.

Aura work: Some animals are in such discomfort – and may also have been so often reprimanded for being sensitive around their heads and necks (horses), or pulled by the collar during training and walks (dogs) – that in some cases the gentlest and easiest way is to start working on them via the aura.

Pain often causes energetic vortexes, and the painful sensation can be relieved by “unscrewing” (counterclockwise) these energy swirls. The animal usually relaxes quickly, may get a downright astounded look on his face (“Wow, someone who is actually not hurting me, this feels good! Who are you?”), and rather than feeling defensive, opens up to participating in the process of getting well again. It’s a thing of beauty. It is important, though, to bring the work “down” to the physical body. This is another opportunistic moment for TTouch.

Acupuncture: Cases with liver involvement are suspect, and so are all meridians that run through the area of reactivity. Can also help with relief of tension type headaches.

Homeopathy: Arnica can work miracles with concussion – keep it on hand for birds flying into windows, or dogs running into closed glass doors. A classical homeopathic workup would not focus on headache, as we always treat the totality of symptoms. Even eliciting specific headache symptoms may prove difficult due to communication of the pain’s location. The “symptoms” we are attributing to headache would be listed, and as the animal responded to treatment based on all other guiding symptoms, the “headache” symptoms would resolve.

Dentistry: May be needed if dental problems were causative. Prolonged periods of keeping the mouth open for the procedure can cause headaches via stress on the TMJ. Using chiropractic, and/or craniosacral work but at the least TTouch soon after the procedure can prevent its development or continuation.

Correctly fitting gear: In most cases, it will take one or more of the treatment modalities above to relieve the symptoms of incorrectly fitting gear, but the cause has to be eliminated for the effects to last. Feeding changes: These may be necessary if horses with suspected headache are receiving too much sweet feed, too many nitrites, or are fed too infrequently. Removing grains and processed foods from the diet can help carnivores.

Training changes: If an animal is asked to hold a posture that is not ergonomical (“Rollkur” in horses), or is otherwise highly stressed physically and/or emotionally, training changes may be needed. Some dogs love agility but may need regular maintenance treatments to prevent headaches.

Combination of modalities: In reality, most of my patients receive a combination of treatment modalities. The initial session may start with chiropractic as the modality of choice requested by the owner. Hyper-reactivity in the head/poll/neck area during chiropractic evaluation leads to use of TTouch, to relax the animal and rule out and treat emotional factors. If reactivity persists, craniosacral evaluation and treatment may be next, followed by acupuncture if needed. This may or may not take more than one session.

Treating animals that exhibit signs of headache can be a highly rewarding undertaking. Without headaches, life is good. Happy animal, happy owner, happy practitioner – voila!